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Did you see the Part I of this lecture?

Tumor necrosis factor " (TNF-") is a multifunctional circulating cytokine derived from endothelial and smooth muscle cells as well as from macrophages associated with coronary atheroma. TNF-" is involved with several cardiovascular processes; it is noted to be increased in advanced heart failure, and in fact, high levels of TNF-" can produce left ventricular dysfunction, pulmonary edema, and cardiomyopathy. Plasma levels of TNF-" were measured in post–myocardial infarction patients enrolled in the Cholesterol and Recurrent Events (CARE) trial with baseline levels drawn an average of 8.9 months after initial myocardial infarction. Overall, TNF-" levels were significantly higher among cases than controls (2.84 versus 2.57 pg/mL, p=0.02). The excess risk of recurrent coronary events after myocardial infarction was predominantly seen among those with the highest level of TNF-"; those with levels in excess of 4.17 pg/mL (the 95th percentile of the control distribution) had an approximately threefold increase in risk (relative risk = 2.7, 95% confidence intervals 1.4–5.2, p=0.004). Risk estimates were independent of other risk factors and were similar to subgroup analysis limited to cardiovascular death or to recurrent nonfatal myocardial infarction.

Ridker PM, Rifai N, Pfeffer M, Sacks F, Lepage S, Braunwald E. Elevation of tumor necrosis factor-" and increased risk of recurrent coronary events after myocardial infarction. Circulation 2000;101:2149-2153.
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